Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 03857 | Date 25/02/2019 |
| Token No | SM/21-22/10233 24/02/2022 | Serial | 036 Last Visit: 08/12/2025 |
| Patient Name | Mrs. RITA SAHA | Contact No | 9331713186 |
| Address | 176 SEORAPHULY N S ROAD,BAIDYABATI(M) | Age | 64 Years,11 Months,6 Days Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||